OBJECTIVE: Pre-exercise stretching (PES) has been common practice prior to participation in athletic events. Despite evidence for lack of benefit, many coaches continue to routinely instruct and prescribe stretching. This study assesses the knowledge, attitudes and practices of high school coaches regarding PES. DESIGN: A cross-sectional survey. SETTING: Multiple high schools in a Southeast Michigan county. PARTICIPANTS: Head coaches (n = 71) at ten county high schools completed the survey. MAIN OUTCOME MEASURES: Knowledge, attitudes and practices of high school coaches regarding PES. RESULTS: The survey was completed by coaches at 10 of 11 public high schools with an overall response rate of 46%. Coaches stretch athletes for an average of 13 minutes prior to practice or competition. Almost 95% of coaches feel stretching is beneficial, specifically in decreasing injury risk. Nearly 73% believe that there are no drawbacks to stretching. The most significant reason cited for stretching is decreased injury risk. Coaches stated that personal experience and scientific evidence are the two factors that would most likely influence their future recommendations regarding PES. There are statistically significant differences in stretching practices between male and female coaches and experienced and inexperienced coaches. CONCLUSIONS: Despite the lack of evidence, nearly all coaches believe that PES prevents a wide array of injuries. Although coaches value personal experience in determining their PES practices, they are open to new scientific evidence, which should encourage the medical community to deliver current research.